MILIARY TUBERCULOSIS OF THE SPLEEN WITH THROMBOPENIC PURPURA HEMORRHAGICA

Abstract

The relationship between the spleen and purpura was recognized many years ago, for Virchow¹stated that "in the case of the hemorrhagic diathesis... it must be regarded as an important step in advance that we are able to point to a definite organ as its source as, for example, to the spleen or liver." The French have long entertained a similar view. Among the more recent studies is that of Winternitz,²who collected fifty-one cases of tuberculosis of the spleen some of which were associated with purpura. In his series all patients died when splenectomy was not performed, and when splenectomy was performed 59 per cent recovered. Tuberculosis of the spleen probably never occurs independently of tuberculosis of other organs. Winternitz uses the term primary tuberculosis of the spleen when the original focus cannot be found or is in a healed state. The disease may run a course